Remote Clinical Validation Auditor III (Nurse)

EXL; Pittsburgh (Allegheny County); À distance; USD 60 000 - 99 000; Plein temps

Résumé du poste

EXL is seeking a Clinical Validation Auditor for a fully remote role based in the United States. You will use clinical judgement to review medical records, validate DRG codes, and help identify overpayments.

The position requires a nursing background with inpatient care knowledge and a meticulous approach. Salary range: $60,100 - $98,700 annually, with up to 10% travel for team meetings and limited client onsite engagements.

Qualifications

• Nurse with inpatient care background and strong attention to detail.
• Experience reviewing medical records for billing accuracy.

Responsabilités

• Review medical records to ensure inpatient care accuracy.
• Validate billed DRG codes for accuracy and fairness.
• Identify potential overpayments and flag discrepancies.

Connaissances

Clinical validation

Medical records review

DRG coding

Nursing/healthcare experience

Description du poste

EXL is seeking a Clinical Validation Auditor for a fully remote role based in the United States. You will use clinical judgement to review medical records, validate DRG codes, and help identify overpayments.

The position requires a nursing background with inpatient care knowledge and a meticulous approach. Salary range: $60,100 - $98,700 annually, with up to 10% travel for team meetings and limited client onsite engagements.